They compared the Moderna and Pfizer vaccines. Which is better for the third dose?

Which vaccine better protects against infection, hospitalization and death from COVID-19: Moderny or Pfizer-BioNTech? This question was asked by the authors of a preliminary study that was recently published in “SSRN”. The study had not yet been reviewed and had limitations, but the results spoke in favor of Moderna. Does this mean it is best suited as a booster dose? – I do not think so – says doctor Bartosz Fiałek and explains why.

1. A comparative analysis of mRNA vaccines, not yet reviewed, suggests that Moderny is more effective in preventing SARS-CoV-2 infection, hospitalization and deaths.
2. Why did Moderny fare better? Commenting on abc.zdrowie, Bartosz Fiałek points out two important issues: in the mRNA-1273 vaccine there is more active agent than in BNT162b2, besides, the recommended interval between doses is longer in the case of the first preparation
3. The doctor points out that the difference in the effectiveness of both vaccines is not significantly higher, so it cannot be said that mRNA-1273 will be better
4. You can find more about the coronavirus on the TvoiLokony home page

Protection against infection, hospitalization and death. Scientists compare mRNA vaccines (non-peer reviewed study)

The approved COVID-19 vaccines that we can use are effective and safe. However, questions are still being asked, could any of them be better? To what extent and to what extent? On January 7, a comparative analysis of the Moderna and Pfizer-BioNTech preparations was published in the SSRN (a kind of repository of preprints, i.e. preliminary versions of scientific publications, not yet reviewed). These are mRNA vaccines, which, however, differ in the “dose” of the active ingredient, intervals between doses, as well as the composition of lipid nanoparticle carriers in which the mRNA is contained.

The analyzes were carried out on two large groups (mostly men). The first were vaccinated with Pfizer-BioNTech (BNT162b2 vaccines), the second – Moderna (with mRNA-1273 vaccine). Participants were vaccinated between December 11, 2020 and March 25, 2021, and had not had COVID-19 prior to vaccination (ethnicity, coexisting diseases were also taken into account). Each group consisted of 902 adults. The mean follow-up was 235 days (192 to 5 months from vaccination).

Scientists collected, among others information on who vaccinated tested positive for SARS-CoV-2, data on hospitalization within 30 days of diagnosis of COVID-19, and data on deaths within 30 days of diagnosis. It is worth noting that the works were carried out at a time when the Delta variant was dominant.

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Moderna’s higher efficiency? Results and Limitations

The observations showed that people who took mRNA-1273 had about 26 percent. lower risk of SARS-CoV-2 infection than BNT162b2 vaccinations. As for the risk of hospitalization and death related to COVID-19, it was lower in the case of Moderny. The difference between the two study groups increased with the passage of time from the end of the vaccination course.

Taking into account the specific numbers, the study showed that 2 became infected in the study groups after vaccination with PfizerBioNTech SARS-CoV-7. 206 people, in the case of Moderna there were 5 thousand. 682. As for the cases of hospitalizations due to COVID-19, there were 162 thousand of them after BNT2b1. 679, after mRNA-1273 – 1 thousand. 185. As for the case of deaths as a result of the coronavirus, it was respectively: 150 and 122 people.

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This study therefore suggests that, with regard to SARS-CoV-2 infection, hospitalization and death, the mRNA-1273 vaccine showed superior efficacy compared to the BNT162b2 vaccine. The safety and comparative efficacy of both vaccines will continue to be investigated. It is also worth remembering about the limitations accompanying the study. The authors note that there were several additional infections and hospitalizations that were not included in the study. In addition, some deaths and hospitalizations following SARS-CoV-2 infection may not be related to infection, and the studied population was predominantly male, so it cannot be excluded that the results may be different for women. After all, only the period of Delta’s dominance was considered in the study.

The doctor comments on the study. Two key things

In the commentary for abczdrowie.pl, Bartosz Fiałek explains why the Moderny preparation fared better. The doctor pays attention to two facts. The first is the higher dose of the active ingredient (that is, in fact, the genetic sequence encoding information about the production of S protein) in the mRNA-1273 vaccine, i.e. 100 micrograms in a 0,5 ml dose (for BNT162b2 it is 30 micrograms in a 0,3 ml dose). – The higher the dose of the active substance, the stronger or faster the action of the preparation – emphasizes Fiałek. On the other hand, the risk of side effects is also greater.

1. Moderna or Pfizer? Which booster provides better protection?

The second issue is the timing of the next doses of the vaccine. In the case of PfizerBioNTech, it is recommended that the second dose be given after 21 days, and for Moderna after 28 days. Bartosz Fiałek reminds that some studies show that if you extend the time between the first and second dose «even up to 16 weeks (studies were conducted with the Pfizer / BioNTech vaccine), a stronger immune response is obtained compared to the time interval of 3-4 weeks» . – It is, of course, about the mild, typical post-vaccination reactions that testify to the stimulation of the immune system, i.e. the generation of an immune response – emphasizes the doctor.

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Moderna is the best booster? Doctor: I don’t think so

Could the above information (the study is preliminary and awaiting review) suggest that Moderna’s vaccine is best suited for primary immunization and as a booster dose? – I do not think so – says Bartosz Fiałek directly, pointing to the fact that the difference in the effectiveness of both vaccines is not significantly higher. – We do not have a situation here in which the Moderna vaccine would be 95% effective and Pfizer-BioNTech 50% effective. The differences are small – emphasizes the doctor in Abczdrowie (protection against COVID-19 in the case of Moderna is 95,9 percent, for Pfizer / BioNTech – 94,5 percent).

– Personally, I started the vaccination course against COVID-19 with the Pfizer / BioNTech vaccine and despite the possible choice, I continue to take the preparation from the same manufacturer – says the specialist. – I do it with full awareness because it is recognized that in the case of mRNA vaccines, vaccination with the same product is preferable (unlike in the case of vector vaccines, where mRNA preparation is recommended as a booster).

Bartosz Fiałek also reminds that mixing vaccines is possible, effective and safe. “(…) the choice is individual, but in the case of mRNA, the dose of the same producer is preferred” – he writes on Facebook.

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